Choosing a Stand-Up Stand-In

By Elizabeth Krivatsy

Someone runs a red light and a paramedic is the next person you see. Or, you awaken from a nap to find that neither your body nor your mind will function. What happens next?

If you don’t choose someone to make decisions when you can’t, decisions will be made anyway. You know this. That’s why it’s so essential that you select a “stand in.”

Here are five characteristics I considered when choosing my stand in:

Someone younger and healthy

If you’re over 75, you might want to choose someone other than your same-age spouse or long-time friend. Or name an adult child as a co-agent to help your spouse. Consider the likelihood that your spouse will be struggling with health issues of his or her own or emotional issues related to your condition.

Someone who knows and respects your priorities

You’ll tell this person your choices, but this person should understand who you are, your spiritual beliefs, the people, and things essential to your life.

Someone who is willing and able to confront authority figures

Although things are changing, most doctors and nurses are taught to cure instead of making life comfortable for the patient. Your agent must be strong enough to say “no” on your behalf. Think Shirley MacLaine in Terms of Endearment.

Someone who knows your family well enough to help in a crisis

Crises call for a good listener, a compassionate heart, and a strong shoulder. Choose someone your family can really lean on.

Someone completely reliable

Not a job for the faint-hearted, a “stand in” is not a responsibility to be given or taken lightly. Choose someone who always shows up.

Posted in Advance Health Care Directives, Estate Planning

"“The past beats inside me like a second heart.”
― John Banville, The Sea (2005)

My younger brother and I spent summers with my dad's mother and our cousins in East Texas (“God’s Country”). My grandmother, Eula Brent Click, was the youngest of 13 children. She taught school in a one-room schoolhouse in Pennington. Rumor has it that she was quite an independent woman for her time, and she married late.

My grandmother was widowed during the Depression. She raised my father and his two older sisters alone, managed the family farm and business in Lovelady, and worked hard to put her kids through Huntsville State Teachers College.

Miss Eula embodied all of the "old-time" virtues - honesty, thrift, simplicity, plainspokenness. She could size you up over the rim of her coffee cup in an instant - and she could spot a lie a mile off. Steeped in the idiom of the King James Bible, she valued good writing, and she could tell a good story and laughed hardest at a good joke.

To be wasteful was a terrible thing. She made play clothes and sun bonnets for me out of calico chicken-feed sacks. She tended a large garden and raised cows and chickens to feed her extended family. She always washed and reused the tinfoil.

Family and church were the two touchstones of her life. There was always someone extra at the table - an aunt, cousins, a visitor - whether for coffee (boiled and tar-black) or dinner. Baptisms and graduations and weddings and funerals punctuated the years. No matter the occasion, there was always plenty of food and storytelling, both of which are competitive sports in my family.

My grandmother taught Sunday School until she was 90. Almost every week she'd pack a food basket for someone who was ill or having a hard time, and we'd drop it off after church. When she was older, nephews and neighbors and church members stopped in to check on her, carry the mail up from the highway, bring her a meal, or help with things around the house, all of which allowed her to live at home until the last year of her life.

I love hearing people's stories - the experiences of a lifetime that shape us all, one way or another. Estate planning, at least in part, is about sharing our legacies and our precious stories with our children and grandchildren.

A longtime friend asked me to help his friend, Harry, a man in his 60s, whose cancer had returned after many years in remission. Harry had worked in the healthcare industry for many years, and he had no illusions about his prognosis and inevitable death. Over the next few weeks, we talked about what he most feared and most hoped for, and how best to ensure that his wishes would be respected.

Together, we created a detailed Advance Health Care Directive, with specific instructions about his end-of-life care, including provisions for spiritual care. We discussed Harry's choices with his adult children, so everyone understood exactly what Harry wanted and why. We also planned for his eventual mental incapacity, so that his children could take care of his financial and personal affairs. Finally, we prepared a revocable trust and pourover will to simplify how his estate would be handled after his death. As he signed the final documents, Harry told me how relieved he felt to have settled everything so that he could focus on being with his children in what time remained.

A few months later Harry died peacefully at home with his youngest son - which was just what Harry wanted.

Seven years ago, Mr. D asked me to help him with his Will. He had never married, and he wanted to leave everything to his favorite nephew in Southern California. Mr. D had lived for decades in a rent-controlled apartment in San Francisco, where he knew everyone in the building by name. While talking with him about his Will, I learned that he recently had suffered a bad fall and was often dizzy. He was having difficulty carrying groceries up the hill to his building, and he wasn’t eating well. It was clear that he was becoming more and more isolated and forgetful.

When I asked Mr. D if he would like to visit some assisted living facilities, he reluctantly agreed. After seeing several facilities in the City, we headed across the Golden Gate Bridge to Mill Valley. It was love at first sight. He chose an apartment overlooking a garden with a beautiful view of Mt. Tam. Despite some initial complaints, within a few weeks, Mr. D was eating regularly and entertaining new friends with his wonderful stories. He even joined the chorus. He knew everybody (and their children and grandchildren) and everybody knew Mr. D. In this safe and supportive environment, Mr. D thrived.